Gene/Protein Disease Symptom Drug Enzyme Compound
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The Copper-T 308A IUD, already popular in Europe and Canada, will soon be available in the US as a result of a new marketing arrangement between the device's developer, the Population Council, and GynoMed pharmaceutical, an independent company that distributes women's health products. Sales of the Copper-T 380A are expected to begin in early 1988. GynoMed has guaranteed that the public sector or clinic price will be half that in the private sector. The company plans to take a conservative, educational approach to the marketing of this new IUD. The device will be sold only to qualified physicians and family planning clinics who confirm that they have read a complete package of information of the product and will convey this information to potential acceptors. In addition, GynoMed and the Population Council have developed very explicit directions as to indications and contraindications of use of the Copper-T 308A. Specifically, women using the Copper-T 308A should be 25 years of age or older; be involved in a stable, monogamous sexual relationship; have had at least 1 child and preferably have completed childbearing; not have a history of pelvic inflammatory disease or any other sexually transmitted disease; and have ready access to medical facilities for follow-up treatment. The device is recommended for women who are breast feeding or cannot use oral contraceptives for reasons such as smoking or hypertension. The Copper-T 380A is considered the safest of all IUDs and has a higher efficacy rate (99.5/100 women/year) than the pill. The device is well accepted by users and has a 12-month continuation rate of at least 60%.
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PMID:Highly effective copper IUD will hit U.S. market in 1988. 1226 26

Prenatal care aims to preserve the health of the fetus and mother. It screens for indications of illness or pregnancy-related complications and tries to prevent them from becoming emergencies. Sufficient referral services are needed for prenatal screening to be effective. Women and their families must be motivated to go to them promptly. Often prenatal care is the first time women receive any medical care. Thus, quality care is imperative so women will again request medical care when necessary. Prenatal care providers must ask women about signs and symptoms of placenta previa and placental abruptio. They should also tell them about the gravity of hemorrhaging in late pregnancy. Referral facilities must have operative capabilities and be able to provide adequate transfusion to treat severe hemorrhage. Health workers must prevent and treat anemia in pregnant women to improve their chances of recovery from blood loss; they must also measure blood pressure and periodically test for proteinuria and edema to diagnose preeclampsia, eclampsia, and hypertension. Health workers must screen women at high risk for cephalopelvic disproportion (e.g. by assessing, height, foot size, and age) and for a malpositioned fetus and multiple pregnancies (e.g. via abdominal examination). They must also educate mothers about the importance of hygienic delivery and provide sanitary delivery kits. Unhygienic delivery conditions and untreated sexually transmitted diseases (STDs) can cause puerperal sepsis. STDs can also have other adverse effects such as ectopic pregnancy and blindness, death, or retardation of the fetus/ infant. STD screening could prevent needless suffering in many women; 5-15% of pregnant women in some developing countries have syphilis. Prenatal care should include screening for urinary tract infections which can cause preterm delivery and low birth weight. Antibiotics can treat these infections. Some pregnant women have infectious diseases which may undetected without prenatal care.
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PMID:How prenatal care can improve maternal health. 1228 37

Evaluation methods are needed to assess nurse practitioners' (NPs') interpersonal skills and provide students with systematic, qualitative feedback. The purpose of this study was to identify characteristics and styles of students' interpersonal behavior from patients' perspectives during simulated encounters. The 29-item Clinical Encounter Q-Set for NPs was generated pertaining to patients' perceptions of their interactions with NP students. Using Q-methodology, simulated patients (SPs) sorted the items immediately after each of their encounters with 45 NP students. Items were rank-ordered along a continuum, ranging from "most like my feelings regarding the encounter" to "least like my feelings." Three interpersonal styles were identified. "Nonjudgmental professionalism" characterized student behavior during the simulation portraying a patient with a sexually transmitted disease. "Competence/confidence" and "empathy/respect" were predominant styles exhibited during the hypertension simulation. The potential value of this method for teaching and evaluation is discussed.
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PMID:Interpersonal styles of nurse practitioner students during simulated patient encounters. 1267 86

We describe the clinical characteristics of 12 HIV-infected patients who suffered from myocardial infarction (MI) in our clinical cohort. They were compared with a control group matched (1:2) for factors related to cardiovascular risk (age, gender, smoking habit, risk factor for HIV acquisition, hypertension, family history for relevant cardiovascular events, and body mass index) by conditional (fixed-effect) logistic regression analysis. Among patients with MI, 6/12 had never used protease inhibitors (PIs) or were antiretroviral therapy naive. The only variables marginally associated with MI were nadir CD4+ T-cell count <50/mm(3) (odds ratio (OR): 7.2; 95% confidence interval (CI) 0.81-64.2; P: 0.077) and zenith >100,000 HIV RNA copies/mL (OR: 7; 95% CI 0.81-60.2; P: 0.076) at univariate analysis. Moreover, the use of PIs did not result in being associated with the risk of MI. Our data show that in HIV-infected patients, PI use does not seem to have any negative impact on MI while the possible impact of advanced HIV infection itself needs further investigations.
Int J STD AIDS 2005 Jan
PMID:Risk factors for myocardial infarction in HIV-positive patients. 1570 66

Abuse, sexual satisfaction, and sexual dysfunction are issues that are not readily addressed in the African-American population, but they are on the minds of many. Ebony decided to pose these and other questions to African-American women in a survey titled, "Are You Satisfied?" Respondents were subscribers to Ebony as well as newsstand readership. Participants either filled out the survey on the Ebony website or sent in a paper copy to be tabulated. African-American women (N=7800) from all walks of life responded and discussed their abuse histories, their relationships, their ability or inability to reach orgasm, their medical histories and level of comfort in discussing their problems with their physicians, as well as many other issues. Results indicate that 37% of the sample self-reported early sexual abuse at the hands of immediate and/or extended family members; 15%-18% have been treated for high blood pressure, STDs/HIV, and/or fibroids; and 33% have experienced an inability to achieve orgasm in the last year. Of the sample 47% stated that they had not discussed these problems with their physicians.
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PMID:The Ebony Sex Survey and the sex lives of African-American women: a call to healthcare providers. 1582 37

Our objective is to analyse patients diagnosed with late-stage HIV infection in the highly active antiretroviral therapy (HAART) area. A prospective, observational study of all patients with an initial CD4 < 50 x 10(6)/L was carried out. Epidemiological, clinical and HAART-associated data were analysed. Survival rates were estimated and pairs of survival curves were compared. The statistical program used was SPSS (version 10). In all, 349 HIV-infected patients were diagnosed, 117 (33.5%) had late-stage disease, mean CD4 23.9 x 10(6)/L and mean viral load (VL) 5.38 log10. In 98 men, mean age 39.5 years, percentage of AIDS cases at their first attendance was 83.8%. The median follow-up period was 28 months and 27 died. Pneumocystis carinii was the most frequent cause of AIDS (24.4%) and death (18.5%). Survival rates at 12, 24 and 36 months were 95.6%, 85.8% and 72.4%. HAART was started in 82.1%. VLs < 50 copies/mL at one, two and three years of treatment were 55.2%, 55.7% and 58.0%. Resource utilization included 0.58 hospitalization/patient/year and 0.07 events/patient/year. HAART-related complications were as follows: 50% lipodystrophy, 9.7% hypertension, 22.2% hyperglycaemia, 26.4% hypercholesterolaemia, 31.9% hypertrygliceridaemia and 18.1% mixed hyperlipaemia. Over one-third of our patients have advanced HIV infection at diagnosis. However, the outcome is favourable, with a good immunovirological response and few new opportunistic events. HAART-related complications were frequent.
Int J STD AIDS 2005 Mar
PMID:Study of patients diagnosed with advanced HIV in the HAART era--OMEGA Cohort. 1582 28

Human behaviour can be viewed as a collective phenomenon, determined partly by the group to which individuals belong. Collectivities of health behaviour have been found in alcohol consumption, hypertension, obesity, mental illness, and sodium intake in that the average level of risk is associated with the percentage of individuals at extremely high risk.The goal was to investigate whether sexual behaviour may be collectively determined. A cross-sectional US survey was conducted. Across 45 states, the mean number of lifetime sex partners excluding persons with >10, >20, and >40 lifetime partners was strongly associated with the proportion with >10, > 20 and > 40 lifetime sex partners, respectively, among men and women. Sexual activity may represent collectively determined behaviour. If so, interventions to reduce high-risk sexual behaviour to prevent HIV or sexually transmitted diseases (STDs) may be more effective if they address the entire population, rather than target only those at the extremes of risk.
Int J STD AIDS 2006 Mar
PMID:The collectivity of sexual behaviour. 1650 99

This study describes differences in health care utilization and recorded diagnoses in a racially and ethnically diverse sample of 1175 out-of-treatment patients who screened positive for heroin and cocaine use during an outpatient visit to a drop-in clinic at an urban hospital. Blacks averaged more ED visits than Whites and higher average yearly ED charges than Hispanics (1,991 dollars vs. 1,603 dollars). Charges over two years totaled 6,111,660 dollars. Blacks were most likely to be diagnosed with injury, hypertension, cardiac disease, alcohol abuse/dependency, and sexually transmitted disease, and least likely to be diagnosed with psychiatric disease. Hispanics were most likely to be diagnosed with HIV, dental disease and drug overdoses, and least likely to be injured. Only 34% of this group of drug users was identified with a diagnosis of drug abuse or dependency.
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PMID:Racial and ethnic differences in health and health care: lessons from an inner-city patient population actively using heroin and cocaine. 1663 73

We examined AIDS stigma among male inmates and male and female staff at a state prison in the southern region of the USA. Inmates and staff rated people with AIDS more negatively than someone with other diseases (diabetes, cancer, heart disease and high blood pressure). Inmates and staff were concerned about being treated differently if they tested seropositive. They also described AIDS stigma as a barrier to seeking HIV testing. Both instrumental (inaccurate beliefs about casual contact causing transmission of the virus) and symbolic factors (negative attitudes about injection drug use) predicted AIDS stigma. Negative attitudes about homosexuality predicted AIDS stigma among Caucasian prison staff and inmates, but not among African American staff and inmates. The results indicate the need to address HIV/AIDS stigma in developing HIV treatment, care and prevention programs in the prison environment.
Int J STD AIDS 2008 Apr
PMID:AIDS stigma among inmates and staff in a USA state prison. 1848 46

Background-Ultrasound elastography is now used worldwide in tissue characterization. The primary premises of elastography are that speckle kinematics reproduces underlying tissue kinematics and that tissue motion can be inferred from speckle tracking. This implicitly assumes that speckle pattern is a material property that can be tracked with respect to time and space. It is then convenient to express the motion of such a material property in terms of total derivative, also known as optical flow (OF) equations. Aims-The present paper introduces a new iterative OF-based elastography (OFBE) method devoted to B-mode data. The first OFBE iteration computes axial and lateral displacement fields. Such displacement fields are used for data rigid registration, prior to the second OFBE iteration which computes the 2-D strain tensor. Methods-The OFBE method was validated in the common carotid artery of rat hypertension models. The effect of aging on carotid stiffness was investigated in female recombinant inbred rats (RI-17, (n=2)) in the first experiment. The outcomes of low/high-salt diets were examined in young male Dahl salt-sensitive rats (SS, n=6; SM12, n=6; SM9, n=6) in the second experiment. Results-Good concordance was observed between left and right carotid axial strain measurements with 11.4% relative error, whereas 4.6% relative error occurred between diastolic and systolic axial strain measurements. Old (80 and 85 weeks) RI-17 carotids were determined to be twice as stiff with 5.70 +/- 0.97% (strain+/-std) as young carotids (30 and 34 weeks) with 13.26 +/- 2.73%, p < 0.001. Carotid axial strain measurement also indicated that salt diets had a significant impact on SS (p=0.008) and SM12 (p < 0.001) but not on SM9 (p=0.881) rats.
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PMID:Optical-flow-based B-mode elastography: application in the hypertensive rat carotid. 2012 56


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